For some Costa Rican feminists, health is power. The Association for Women in Health (AMES) blends health and activism by selling health care that empowers women to take control of their bodies and prevent disease, and using the proceeds to enable low-income women to do the same.
“We believe that health is not something doctors can give you,” said Anna Arroba, director and founder of AMES. “We believe that health is something people have to create for themselves and by themselves.”
Working with the idea that diet, exercise and emotional well-being can prevent diseases more effectively than medicines, the association promotes education, counseling and a mix of alternative medical treatments and traditional clinical services.
The organization offers these services at its office in the eastern San José neighborhood of Los Yoses and uses the profits to provide empowerment training and medical services to women in poor communities such as Alajuelita, south of San José.
Besides gynecological consultations and psychological services, the organization offers alternative treatments including massage, yoga, reiki – a treatment that works on the basis of touch at acupuncture points –and apitherapy, which uses bee stings at similar points to reputedly reduce symptoms of everything from asthma to depression and diabetes.
The treatments vary in price from ¢1,500 (about $3) for a pregnancy test to ¢15,000 ($30) for a reiki session. Other prices include ¢13,000 ($26) for a medical consultation; ¢5,000 ($10) for a Pap smear test; ¢15,000 for a first apitherapy session and ¢6,000 ($12) for a follow-up; and ¢15,000 a month for twice-weekly yoga classes.
AMES has funded the project in Alajuelita since it began in 2000 with proceeds from these types of medical services.
The organization’s members bring the women free health services on the last Saturday of each month, and they teach young women about issues including domestic and sexual violence, sexual health, contraception and nutrition, and train them to inform others.
On occasion, they also bring food to the poorest women in the community. The goal is for the women in the program “to be in charge of their own health and also to be a central point in the community for other women,” said Arroba, adding that AMES aims to promote self-sufficiency in the community.
The program costs more than $10,000 a year, which is one reason why Arroba is promoting alternative therapies in hopes of attracting more paying patients to the clinic.
Teresa Guadamuz, one of about 50 women in Alajuelita who are part of the program, said it has done a lot of good for the community.
“Because I live here I can see the advances women have made in their holistic health and the way they value themselves as human beings,” said Guadamuz, who was one of the women trained in the program. She now distributes contraceptives and advice in her community.
As part of the program, women in Alajuelita have also learned to file complaints in cases of violence, she added.
Looking to expand its community programs, AMES is planning a project to educate indigenous women from the southern region of the country.
During a recent visit to the AMES office in Los Yoses, María Bejarano and Martina González, both from the Guaymí indigenous community in southern Costa Rica’s Coto Brus, said they hope AMES can help them.
Sitting in the office’s kitchen, Bejarano, a soft-spoken woman dressed in indigenous clothing, was taciturn at first, as she mentioned the abandonment, unplanned pregnancies and violence her community has faced. She opened up when discussing her concern about young people in her village, who she said are hanging out in the street at early ages and getting into risky situations.
“Ten-year-old girls already have boy-friends,” she said, adding that parents in the community are having trouble controlling their adolescent children.
Arroba, 59, who was born in England to a British mother and an Ecuadorian father, founded the Association for Women in Health in 1997.
After arriving in Costa Rica in 1980, she observed that the Costa Rican health system was filled with mostly male doctors, and she wanted to create an organization that would focus on health from a woman’s perspective, she said.
To truly be healthy, women need to be selfish enough to focus on their own needs, something they have traditionally not been allowed to do in male-oriented societies, she added.
AMES promotes the idea that this personal focus can help prevent diseases such as cancer and sexually transmitted diseases, as well as social problems including sexual and domestic violence and unwanted pregnancies.
Funded partially by the U.S.-based Planned Parenthood, AMES is one of relatively few Costa Rican organizations that offers counseling on contraceptives and gives out information on reproductive and sexual health from a feminist perspective.
But convincing people to focus on prevention can be a difficult task, especially in Costa Rica, where teen and adolescent pregnancy is high, and sex education in schools is a subject of constant controversy.
AMES confronts this problem by taking a multi-pronged approach to activism: in addition to providing health services and running community education projects, the organization gives lectures and counseling, and lobbies the Legislative Assembly on controversial issues such as the potential legalization of the morning-after birth control pill.
“Health is a very political issue when it comes to women,” she said. “By including women’s experiences… we are strengthening the capacity to be citizens – to be active, healthy, sexual citizens.”
The Association for Women in Health (AMES) office is in the eastern San José neighborhood of Los Yoses, 300 meters south, 100 meters west and 75 meters north of the AutoMercado. Find a Papaya-colored, two-story house with a sign that says AMES. For information, call 224-3678.